Pre-eclampsia: A hypertensive Disorder During Gestation

Pareek, Shatrughan

doi:10.21088/jnmmh.2454.7506.6120.3

Cited by 5 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of pre-eclampsia in India is as high as 10%[ 6 ] while the rate of eclampsia that varies from country to country is found to be around 3.8% in hospital patients. [ 7 ] Here we saw a higher number of patients with eclampsia.…”

Section: Discussionmentioning

confidence: 99%

Description and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in North-Eastern Bihar: A retrospective study

Dasari¹,

Jacob²,

Jeyapaul

et al. 2022

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Background: Hypertension is one of the most common medical disorders complicating pregnancy. In India, high blood pressure contributes to 7.1% of maternal deaths. This study was carried out to describe the characteristics and pregnancy outcomes of patients presenting with eclampsia or pre-eclampsia to a secondary care hospital in rural India. Methods: Patients diagnosed with pre-eclampsia or eclampsia between January 2018 and April 2021 were identified and included in the study. Medical records were searched and general patient characteristics, obstetrical history, information about the antenatal period, mode of delivery and outcomes were documented and analysed. Results: Among the 3651 women who delivered in this hospital during this time period, 2.3% ( n = 83) presented with eclampsia and 1.9% ( n = 71) with pre-eclampsia. More than 50% of the women delivered by lower segment caesarean section among both the eclamptics and pre-eclamptics. The stillbirth rate among those with either pre-eclampsia or eclampsia was 1 per 1000. The number of low birth weight babies born to those presenting with eclampsia (66.7%) was significantly more than those presenting with pre-eclampsia (48.6%). Eclampsia/pre-eclampsia accounted for 21% of all maternal deaths with a case fatality rate of 2.6%. Conclusions: This study identified that in this setting the patients presenting with eclampsia were much higher than those presenting with pre-eclampsia which is in stark contrast to the status even in developing countries. This could be an important finding indicating poorer health-seeking behaviour among the population and will need more studies on various interventions to change this status.

show abstract

Section: Discussionmentioning

confidence: 99%

Description and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in North-Eastern Bihar: A retrospective study

Dasari¹,

Jacob²,

Jeyapaul

et al. 2022

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

show abstract

“…Pre-eclampsia is associated with maternal and fetal morbidity and mortality. In developing countries, the incidence of pre-eclampsia is 7 times higher as compared to the developed countries [7]. Cerebrovascular accidents during pregnancy are uncommon disorder but it is significant because case fatality is up to 20% [8].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy/abortion induced intracerebral hemorrhage during the first trimester in a young female

Kumar¹,

Gupta²,

Kalra³

et al. 2021

IJCR

View full text Add to dashboard Cite

I ntracranial hemorrhage (ICH) is a relatively infrequent but devastating complication of pregnancy that accounts for the third most common cause of non-obstetric related maternal mortality. Intracranial hemorrhage in pregnancy can manifest as extradural, subarachnoid, intracerebral, and intraventricular bleeds. Mostly, these events occurs during the second or 3 rd trimester [1,2]. The prevalence of stroke in pregnancy and puerperium appears in 10-34/100,000 parturient women and it is a major reason for the morbidity and mortality among pregnant women. In various countries, eclampsia and stroke during pregnancy are major factors of maternal and neonatal death [3]. Pregnancy-associated ICH is a rare but severe complication. The estimated mortality of pregnancy-associated ICH is 9-38%, which contributes to more than 12% of all maternal mortality in most nations. The incidence of pregnancy-associated ICH in developing countries is even higher than that reported in other countries [4].Importantly, ICH arising in pregnancy or postnatal is often due to new-onset preeclampsia and eclampsia, mainly when acute hypertension is uncontrolled [5]. Worldwide, 10% of all pregnancies become complicated due to hypertension, pre-eclampsia, and eclampsia. These factors are the major causes of maternal as well as antenatal morbidity and mortality. At the global level, it is evaluated that pregnancy-induced hypertension (PIH) affects about 5-8% of all pregnant women [6]. Advanced maternal age, African American race, hypertensive diseases, coagulopathy, and tobacco abuse were all independent risk factors for pregnancy-related ICH [1]. In this backdrop, we present a firstof-its-kind case of intracerebral hemorrhage complicating the first trimester at 12 weeks of gestation without overt predisposing factors. CASE REPORTAn 18-years-old unmarried female was brought to AIIMS, Jodhpur emergency department with a history of unconsciousness, leftsided weakness, and aphasia on June 11, 2019. The patient was shifted to the hospital after 1-2 h of unconsciousness. The patient's mother explained that the patient is not able to communicate with her along with no movement of the left-sided upper and lower limb with right-sided facial deviation. There was no history of fever, headache, nausea, vomiting, seizure, bowel, and bladder incontinence. The history of the patient revealed that there was no history of hypertension, diabetes, hospitalization, blood transfusion, and epilepsy. The patient has a normal menstrual

show abstract

“…In India, PE is reported to be 8%-10% among pregnant women. 23,24 According to a study, the prevalence of hypertensive disorders during pregnancy was 7.8%.…”

Section: Introductionmentioning

confidence: 99%

“…A detailed understanding of PE pathogenesis from an immune surveillance point of view is helpful to address the pathobiology of this disease and take effective steps toward risk mitigation and avoiding fetomaternal casualties. In India, PE is reported to be 8%–10% among pregnant women 23,24 . According to a study, the prevalence of hypertensive disorders during pregnancy was 7.8%.…”

Section: Introductionmentioning

confidence: 99%

New immune horizons in therapeutics and diagnostic approaches to Preeclampsia

Mukherjee

Singh

Karmakar

et al. 2023

American J Rep Immunol

View full text Add to dashboard Cite

Hypertensive disorders of pregnancy (HDP) are one of the commonest maladies, affecting 5%–10% of pregnancies worldwide. The American College of Obstetricians and Gynecologists (ACOG) identifies four categories of HDP, namely gestational hypertension (GH), Preeclampsia (PE), chronic hypertension (CH), and CH with superimposed PE. PE is a multisystem, heterogeneous disorder that encompasses 2%–8% of all pregnancy‐related complications, contributing to about 9% to 26% of maternal deaths in low‐income countries and 16% in high‐income countries. These translate to 50 000 maternal deaths and over 500 000 fetal deaths worldwide, therefore demanding high priority in understanding clinical presentation, screening, diagnostic criteria, and effective management. PE is accompanied by uteroplacental insufficiency leading to vascular and metabolic changes, vasoconstriction, and end‐organ ischemia. PE is diagnosed after 20 weeks of pregnancy in women who were previously normotensive or hypertensive. Besides shallow trophoblast invasion and inadequate remodeling of uterine arteries, dysregulation of the nonimmune system has been the focal point in PE. This results from aberrant immune system activation and imbalanced differentiation of T cells. Further, a failure of tolerance toward the semi‐allogenic fetus results due to altered distribution of Tregs such as CD4+FoxP3+ or CD4+CD25+CD127(low) FoxP3+ cells, thereby creating a cytotoxic environment by suboptimal production of immunosuppressive cytokines like IL‐10, IL‐4, and IL‐13. Also, intracellular production of complement protein C5a may result in decreased FoxP3+ regulatory T cells. With immune system dysfunction as a major driver in PE pathogenesis, it is logical that therapeutic targeting of components of the immune system with pharmacologic agents like anti‐inflammatory and immune‐modulating molecules are either being used or under clinical trial. Cholesterol synthesis inhibitors like Pravastatin may improve placental perfusion in PE, while Eculizumab (monoclonal antibody inhibiting C5) and small molecular inhibitor of C5a, Zilucoplan are under investigation. Monoclonal antibody against IL‐17(Secukinumab) has been proposed to alter the Th imbalance in PE. Autologous Treg therapy and immune checkpoint inhibitors like anti‐CTLA‐4 are emerging as new candidates in immune horizons for PE management in the future.

show abstract

Pre-eclampsia: A hypertensive Disorder During Gestation

Cited by 5 publications

References 0 publications

Description and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in North-Eastern Bihar: A retrospective study

Description and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in North-Eastern Bihar: A retrospective study

Pregnancy/abortion induced intracerebral hemorrhage during the first trimester in a young female

New immune horizons in therapeutics and diagnostic approaches to Preeclampsia

Contact Info

Product

Resources

About